If you are supposed to bill pdgm, then you do need a hipps code so you have to pick the correct option for M00150.
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Kelly Rader
Sent: Monday, February 20, 2023 9:14 AM
To: billers@list.mnhomecare.org
Subject: RE: UCare claims
Did you have any luck with billing like this? Adding the 50 occurrence code? I tried and it did not work. I have a question about MSHO members
where we are billing the T1030 code. We do not fill out the Oasis like Medicare so there is no HIPPS
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Did you have any luck with billing like this? Adding the 50 occurrence code? I tried and it did not work. I have a question about MSHO members where we are billing the T1030 code.
We do not fill out the Oasis like Medicare so there is no HIPPS code so how will they know how to pay if that is what they are wanting?? So confused. I tried the 50 occurrence code with the date of the assessment and it got denied, again.
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Mortenson,Crisa
Sent: Wednesday, February 15, 2023 3:03 PM
To: billers@list.mnhomecare.org
Subject: Re: UCare claims
I'm going to try and rebill my FFS claim on the one patient I had a denial on and include the occurrence code 50 with the appropriate date and see if that
pays. I love how they tell us to refer to the CMS billing guideline booklet, which is 100 pages long...
Crisa Mortenson
Billing Officer
Phone:
218-843-3852
Fax : 218-843-2311
Email: crisa.mortenson@kmhc.net
1010 S Birch Ave. P.O. Box 700
Hallock, MN 56728
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Mary Hanson <mhanson@rvhci.com>
Sent: Wednesday, February 15, 2023 1:59 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] UCare claims
Hello All,
Finally received a remittance today with many January claims that had been unprocessed. Some of these had shown in their system as pending with an amount of payment but unfortunately
many claims denied. Reason Code M79 – Missing/incomplete/invalid charge.
I did talk to provider services today. Here is what I was told:
“Refer to the provider bulletin which reference CMS billing guidelines. Missing Occurrence Code 50 with bill type 032X.”
My question to the group is what is everyone doing when they bill these claims with the plans they list in the bulletin. Are they wanting PPS billing? Are you sending NOA’s?
One plan involved is UCare Connect + Medicare. So, even though these are Medicaid claims they are processing them as Medicare? I’m sorry but I am confused.
Any help on what you are doing that is working is greatly appreciated!!
Thank you.
Mary Hanson | Billing Specialist |
River Valley Home Care Inc.
916 8th Street Farmington, MN 55024
Phone: 651-460-4201
Email:
mhanson@rvhci.com
Mary Hanson | Billing Specialist |
River Valley Home Care Inc.
916 8th Street Farmington, MN 55024
Phone: 651-460-4201
Email:
mhanson@rvhci.com
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